Walden NURS6640 Final Exam Course NURS-6640 Psychotherapy Individual
Review Test Submission Week 11 Final Exam: Walden NURS6640 Final Exam Course NURS-6640 Psychotherapy Individual
Course NURS-6640 Psychotherapy Individual
1 A PMHNP is using Gestalt therapy to communicate with a 50-year-old patient who is going through a divorce.
As he is calmly sharing the details of his divorce, the PMHNP notices that Dave
is tapping his fingers on his legs. What is an appropriate response by the
PMHNP using the technique of focusing?
25-year-old female states, “I really need to lose weight. I know I’m the cause
of our problems, if I could just lose
weight he might be more attracted to me. Then we could start a family and we
would be happy. I’m sure of it, right, we would definitely be happy!” Which
statement shows the PMHNP’s ability to apply “summarizing”?
of the PMHNP’s role in the clinic, the PMHNP oversees students that gain
clinical experience at the agency. The student is instructed to use the
supportive psychodynamic therapy approach with the patient. Which action made
by the student causes the PMHNP to intervene, after observing the student interacting
with the patient?
is using motivational interviewing (MI) with a 50-year-old patient named Dave
to commit to a healthy drug-free lifestyle. By using “change talk,” the PMHNP
hopes to help the patient build self-esteem and hope.
True or false: If Dave is resisting change, the PMHNP should
challenge his resistance in order for MI to be successful.
5 The PMHNP is actively listening
to Ms. Thomas who is detoxing from alcohol. Ms. Thomas is currently discussing
with the PMHNP the reasons why she feels guilty about her drinking. Ms. Thomas
tearfully states, “I have driven my family and friends away with this terrible
habit. I have no one left. I had more than enough chances and now my children
won’t even talk to me.” Which of the following statements demonstrate a simple
6 A PMHNP is using Gestalt
therapy to communicate with a 42-year-old patient who is upset with her mother.
She says, “I want to tell her how hurt I feel when she doesn’t call me, but I
don’t want to upset her.” What technique can the PMHNP use to help Sasha
7 The PMHNP is meeting with an
older, female adult patient and her daughter. The patient has early onset
dementia. The daughter expresses concern, saying, “I don’t want you to just
stick my mother in a home and give her medicine. I’m worried that’s what people
are going to want to do.” What is the best response by the PMHNP to the
8 The PMHNP meets with a
31-year-old woman who reports feeling as though she is “at her breaking point”
with work. The PMHNP learns that the woman works 12-hour days, including one
day on the weekend, because she is nervous about company layoffs. “I feel like
I need to work myself to death in order to prove that I am valuable to the
organization,” the woman says. Using the supportive psychodynamic therapy
approach, how does the PMHNP respond?
9 When preparing to terminate a
patient, what does the PMHNP do to organize thoughts about the patient’s progress
made during treatment?
10 Linda is a 65-year-old patient
who has completed initial treatment for alcohol addiction and anxiety problems.
She is motivated to continue her treatment gains and have a healthy lifestyle.
How would the PMHNP apply a mindfulness approach to this case?
11 The PMHNP is caring for a young
adult patient with whom the PMHNP decides to use a dynamic supportive therapy
approach in addition to pharmacological intervention. Which therapeutic action
will the PMHNP take to employ the strategy of holding and containing the
12 The PMHNP is caring for an adult
male patient whose wife left him several months ago. He recently learned that
his ex-wife is dating someone much younger. The man feels belittled, sad, and
lonely. He talks about trying to meet other women, but says, “I can’t compete
with the younger guys these days, with the cool clothes and the vegan diets.
I’m bald and overweight, and what woman is going to want to be with me?” How
does the PMHNP help raise the man’s self-esteem?
13 A 43-year-old single mother is
seeing the PMHNP at the request of her sister. “My sister thinks I need to come
here to talk about my feelings,” the patient reports. The PMHNP learns that the
patient has three children from three different men, but is unable to collect
appropriate child support payments from any of the biological fathers.
Additionally, the woman is barely able to afford her apartment or utilities
payments. What is the appropriate response from the PMHNP when using the
psychodynamic psychotherapy technique?
14 The PMHNP has been providing
interpersonal psychotherapy (IPT) for a patient who the PMHNP observes
implementing new ways of being, such as interacting more with peers and being
less isolated in social scenarios. The PMHNP understands that the patient is
approaching termination. How does the PMHNP address termination with this
15 A PMHNP has been treating a
14-year-old patient using interpersonal psychotherapy. The patient has been
depressed since the death of his grandmother. To help the patient recover, the
PMHNP has told the parents:
16 In the planning phase of change,
a 42-year-old male client who struggles with gambling discusses how he plans to
abstain from gambling. He tells the PMHNP, “I am no longer going to carry cash
to the casino because you can’t spend what you don’t have.” The PMHNP uses an
affirming communication skill when she states:
17 The PMHNP is assessing a patient
who has been receiving months of outpatient psychotherapy. According to the
PMHNP’s assessment, the patient is nearing the termination phase of their
therapeutic relationship because the patient’s symptoms have improved, and the
patient shows progress managing behaviors and decision-making abilities
according to the diagnosis. How does the PMHNP approach termination with this
18 The PMHNP is caring for a
patient who is histrionic. Using the supportive psychodynamic therapy model,
what is the best statement made by the PMHNP?
19 A cocaine-addicted female
patient is entering residential treatment for substance abuse. Using the 10
guiding principles of recovery, an appropriate step by the PMHNP is to
20 A PMHNP is assessing a
40-year-old patient named Sarah who has a severe cocaine addiction and mild
depression. Using the four-quadrant model, what would be the most appropriate setting
to help the patient?
21 A 21-year-old patient has been
having trouble adjusting to college life. She tells the PMHNP that she had five
alcoholic drinks at a party this past weekend. She also acknowledges that she
drank the same amount of alcohol at a party the previous month. Based on this
information, what would the PMHNP most likely recommend?
22 A PMHNP is using emotion-focused
therapy to help a 38-year-old patient who says, “I’ve been feeling angry
lately, but I’m not sure why.” The first attempt by the PMHNP is to say:
23 The PMHNP uses the Adult
Attachment Interview (AAI) with a male patient who reports having had a
difficult time being separated from his parents during his childhood. He
explains that going to school or visiting his relatives without his parents was
troublesome. The PMHNP characterizes the patient as unresolved/disorganized,
according to his outcomes on the AAI. What does the PMHNP anticipate from the
24 The PMHNP is interviewing a
patient who is in the process of successfully completing a substance abuse
program. During the interview, the patient states, “I wish I was strong enough
to keep the same friends I had before I came here for treatment. I’m really
afraid of being discharged because I’ll probably run into my old friends
again.” The PMHNP offers a complex reflection when she states the following:
25 A PMHNP is using interpersonal
psychotherapy with a 40-year-old patient having relationship problems with his
extended family. The patient shares that he has been using the strategies they
identified to reduce his distress, but they have not been helping. He is
frustrated and is considering stopping treatment. What would be an appropriate
step by the PMHNP?
26 An 8-year-old has been having
trouble making friends at school. His parents initiated treatment when he also
started acting out at home. Which is the most appropriate step that the PMHNP
takes during the assessment process when using an integrated approach?
27 The PMHNP is treating an older
adult patient who reports symptoms of late-life anxiety. What type of treatment(s)
will the PMHNP consider?
28 The PMHNP is assessing a patient
who requires cognitive behavioral therapy (CBT). Which of the following
statements made by the PMHNP approach the termination phase for this patient?
29 A patient’s depression is
affecting her relationship with her spouse. What might the PMHNP ask during the
initial sessions of interpersonal psychotherapy treatment?
30 A PMHNP is treating a
10-year-old boy who is exhibiting signs of aggression and attention problems.
What type of intervention will the PMHNP consider using a common elements
31 The PMHNP who practices
motivational interviewing understands its relationship to patient behaviors
and/or outcomes to mean which of the following?
32 A PMHNP is treating a
12-year-old girl who witnessed the physical abuse of her sibling. She has been
anxious and irritable since the experience. After speaking with the PMHNP, the
patient says she keeps having anxiety-causing thoughts about the experience.
Using the PRACTICE technique, which skill will best help the patient interrupt
these negative thoughts?
33 The PMHNP is working with a
patient who describes having a painful and traumatic childhood experience,
which causes her to have anxiety as an adult. When asked how she manages her
anxiety, the patient dismisses it and denies that it is a problem. Using the
supportive psychotherapy approach, the PMHNP will do which of the following
when assessing the patient’s ego strength?
34 The PMHNP uses therapeutic
communication skills while ensuring that the patient understands that he has
choices. The PMHNP comprehends and practices motivational interviewing. This is
best understood as which of the following?
35 While assessing a patient using
a humanistic-existential approach, a patient tells the PMHNP, “For the past few
weeks, I’ve felt anxious almost every single day.” What would be an appropriate
next step by the PMHNP?
36 The PMHNP is meeting with a
patient who has been diagnosed with depression. The patient is having trouble
adjusting to her new job and hasn’t made any new friends there. What would an
appropriate response be by the PMHNP using the interpersonal psychotherapy approach?
37 A 38-year-old patient tells the
PMHNP that her father went to jail for selling drugs when she was a child. The
patient is visibly upset when discussing what happened. Using a
humanistic-existential approach to psychotherapy, which of the following is the
most appropriate response by the PMHNP?
38 The PMHNP is assessing an older
adult male patient with depression and comorbidities. According to the medical
chart, the patient takes medication to manage joint and bone pain. The patient
reports feeling “forgetful” and complains that he has a hard time remembering
where he puts things. What is the primary action by the PMHNP?
39 A 35-year-old male patient is
being treated for alcohol addiction. He asks for the PMHNP’s cell phone number
to use in case of an emergency. When the PMHNP responds that giving her number
would be against therapeutic rules, the patient threatens an act of violence to
the therapist. What would be the most appropriate response by the PMHNP?
40 The PMHNP is caring for a
geriatric patient who expresses symptoms of gastrointestinal problems, aches
and pains, and loss of appetite. The patient reports feeling lonely, as more of
his friends have been passing away over the recent months and years. The PMHNP
focuses on which therapeutic approach for this patient?
41 A 12-year-old girl was referred
for treatment after witnessing the physical abuse of her sibling by their
mother. The patient has been anxious and irritable since the experience. What
evidence-based treatment would be most appropriate for the PMHNP to use?
42 The PMHNP uses the cognitive
behavioral therapy model with Gerald, an older adult patient who is being
treated for depression and mood disorder. What will the PMHNP do with the
patient during the first three sessions?
43 The PMHNP is initiating a plan
of care for a patient who requires comprehensive psychotherapy to manage his
depression and mood disorder. Throughout the initial sessions, the patient
reports feeling as though he cannot be helped. The PMHNP is concerned about
premature termination initiated by the patient. What strategy can the PMHNP
employ to prevent or reduce premature termination?
44 How does the PMHNP approach
termination with the patient who has been receiving intermittent therapy?
45 A PMHNP is treating a
25-year-old patient who has a compulsive urge to exercise to excess. When asked
to describe why she does so much exercise, she says, “I like the compliments I
receive from others on my new level of fitness, and the excitement of getting
more attention.” The PMHNP can use feeling-state therapy to help Monique
46 A 19-year-old female patient
named Anna, who was the victim of child abuse and neglect, is also in treatment
for substance abuse. At her most recent appointment, Anna confesses to the
PMHNP that she is having romantic fantasies about him, and explains the he is
one of the few people she trusts. She believes that he is interested in her as
well. What is the most appropriate response by the PMHNP in this situation?
47 A 21-year-old patient is worried
about starting a new job. She talks about her fears of failure and not making
friends at the office. Using a person-centered approach, an appropriate
response by the PMHNP is to ______________.
48 The PMHNP initiates
feeling-state therapy to help a 25-year-old patient named Monique who has a
compulsive urge to exercise. Using the Feeling-State Addiction Protocol, what
is an appropriate next step the PMHNP should take after identifying the
specific positive feeling linked with the addictive behavior and its Positive
Feeling Score level?
49 The PMHNP is caring for an older
adult patient who presents with mixed dysphoric states and whose daughter
reports “is becoming more irritable more easily.” When talking with the
patient, the PMHNP also recognizes displays of cognitive dysfunction. Which
treatment options will the PMHNP most likely suggest?
50 Following an attempted suicide,
Mr. Durham was admitted to an acute psychiatric facility. After 4 weeks in
treatment, he is preparing for discharge. He is beginning to miss individual
and group therapy sessions and has refused medications twice in the past 2
days. The PMHNP demonstrates understanding in this phase by saying which of the
51 The PMHNP assesses a 27-year-old
patient named Jeff, who was a victim of child abuse and neglect. Jeff says that
he remembers a traumatic situation that he wants to share, but is having
trouble talking about it. Which statement made by the PMHNP demonstrates the
use of emotion-focused therapy?
52 The PMHNP has been providing
supportive psychodynamic psychotherapy to a patient and is nearing the
termination stage. The PMHNP will use which criteria for determining that the
patient is ready for termination?
53 The PMHNP has been treating a
patient who is now being transferred to another provider. What is the appropriate
action made by the PMHNP?
54 A PMHNP has been treating a
9-year-old patient who was referred by her school. Students are asked to raise
their hands before speaking during group discussion, but the patient seems to
blurt out what she wants to say without being called on. She also interrupts
other children while they are talking instead of waiting her turn. When the
patient gets frustrated, she has trouble controlling her emotions and cries
often. Based on the initial information provided, the first focus by PMHNP is
the child’s ____________.
55 When completing this exam, did
you comply with Walden University’s Code of Conduct including the expectations
for academic integrity?
56 A 38-year-old patient has been
having trouble communicating with his teenage daughter. Using a
solution-focused therapy approach, the PMHNP responds by saying, “When was a
time that a communication problem could have occurred, but did not?” In this
case, what type of question is the PMHNP asking?
57 A patient is finishing the
active treatment phase of interpersonal psychotherapy (IPT). After the PMHNP
reminds the patient that she has three sessions left, the patient says nothing,
but looks distressed. What would be the best reply by the PMHNP following IPT
58 The PMHNP is in the process of
terminating treatment with a patient who witnessed the death of her parent who
used to sexually abuse her. What does the PMHNP understand about terminating
59 The PMHNP is caring for an older
patient with major depressive disorder, seasonal pattern. The patient has been
resolute about not taking medication to manage the depression brought on by his
illness, stating that it is against his yogic lifestyle. In addition to
psychotherapy, what can the PMHNP suggest to this patient?
60 The PMHNP is caring for an older
adult patient who is in the acute phase of schizophrenia. Which therapeutic
model will the PMHNP employ with this patient?
61 A PMHNP is assessing a
60-year-old patient named Carlos. He has severe PTSD and mild substance abuse
issues. The most appropriate setting to treat Carlos would be a _________.
62 The PMHNP is terminating
treatment for a patient who has been receiving eye movement desensitization and
reprocessing (EMDR) therapy. What action does the PMHNP take at the final
session to terminate treatment?
63 The PMHNP is treating an older
adult patient who reports experiencing nightmares associated with an automobile
accident he was in 20 years ago. As the PMHNP formulates the case using the
dynamic supportive therapy model, what questions will the PMHNP use during the
64 The PMHNP is assessing a new
geriatric patient who reports symptoms of depression. The PMHNP wants to
identify the patient’s symptom severity over time. Which assessment tool will
the PMHNP use to collect this data on the patient?
recalling the phases of change, the PMHNP demonstrates “open questioning” in
the “engagement” phase by making which statement?
patient recovering from substance abuse tells the PMHNP, “It’s impossible to
meet new people. I really hate being single.” Using existential psychotherapy,
what might the PMHNP say next?
PMHNP is communicating with a middle-aged male patient who has a history of
addiction to Percocet (acetaminophen/oxycodone). The patient suddenly yells, “I
do not have a problem with pain pills! I’ve never had an overdose and no one
even knows that I take them unless I tell them.” The PMHNP understands that
there are phases of change and can best demonstrate “focusing” by responding
PMHNP is terminating treatment with a patient who is aggressive and has a
history of anger. What does the PMHNP do when terminating treatment with this
PMHNP is assessing a 30-year-old client who reports feeling stressed out due to
his current employment situation. When asked about how he manages this
work-related stress, the patient says that exercise helps him feel less
anxious, so he often spends 2 or more hours at the gym each night. After
completing the patient assessment, the PMHNP has determined that an existential
psychotherapy approach may best benefit this client. What is the PMHNP’s goal
in employing this treatment approach?
PMHNP is interviewing a patient with a history of substance abuse. He has
attempted to stop abusing drugs three times before. He states to the PMHNP, “I
just cannot change. How can you help me?!” As it applies to change, the PMHNP
understands the principle of evocation to mean:
has been working with a 50-year-old patient who has a stressful job and goes to
the casino on weekends to play poker with his friends, which he says relieves
his stress. Tim admits that he sometimes misses work on Monday when he stays
out too late at the casino on Sunday nights. In addition, he once was an avid
runner, and has given up running to spend more time gambling.
True or false: According to the PMHNP, the desired goal
after treatment is not complete abstinence from gambling, but reaching a healthy
level of the behavior.
PMHNP is caring for a patient who experiences depression caused by the
traumatic experience of her dog passing away. She reports not being able to eat
or sleep, and sometimes doesn’t want to leave the house at all. Which statement
is most appropriate for the PMHNP to maximize the patient’s adaptive coping
13-year-old patient and his parents are meeting with a PMHNP. When the PMHNP
says hello, the boy just nods. His parents tell the PMHNP that he didn’t want
to come to the session, but they insisted. They explain that their son has been
moody and depressed at home, but is still getting good grades at school. Which
of the following would be the best response by the PMHNP?
PMHNP is initiating a plan of care for Holly, a 73-year-old female patient who
has late-life bipolar disorder and reports consuming alcoholic beverages four
times per week. What is the focus of Holly’s therapy going to be?
PMHNP continues to meet with Gerald, who is the patient with depression and
mood disorder. The PMHNP uses the CBT approach. Gerald is now meeting with the
PMHNP for his fifth session and feels comfortable with how the therapy works.
What does the PMHNP plan to do with Gerald over the course of the next several
a 75-year-old patient who has completed initial treatment for depression. What
might a PMHNP ask Mia when using a solution-focused therapy approach?